Serum Selenium Concentration in Neurosurgery Patients Receiving Parenteral Nutrition

Selenium is an important trace element that helps maintain physiological functions. We calculated the incidence of selenium deficiency in enterally and parenterally fed patients with acute neurologic disorders.

We enrolled 39 consecutive patients who received enteral and/or parenteral nutrition for 14 days or longer (23 men, mean age 74.6 years). Serum selenium was recorded on admission and at 2 weeks and 1 month thereafter. Low selenium was defined as a level lower than 107 μg/L. A diagnosis of selenium deficiency was based on the clinical guidelines for selenium deficiency.

The mean serum selenium level at admission was 119.9 μg/L in 38 patients but was lower in the 39th patient, who had undergone prolonged tube feeding. There was a weak negative correlation between selenium level and patient age, and when the age cutoff for detecting low selenium was set to 75 years, the sensitivity was 91.7% and the specificity was 53.8%. No selenium-deficient patients presented with clinical symptoms associated with selenium deficiency (all had subclinical low selenium). Selenium was normal in 26 patients, although 2 presented with low selenium 2 weeks post-admission. At 1 month after admission, no patient had a low selenium level.

Our findings suggest that selenium measurement on admission may be advisable for patients aged 75 years or older and for those undergoing hemodialysis or prolonged tube feeding. Selenium deficiency is a concern when neurosurgery patients with acute neurologic disorders are fed enterally or parenterally.